Dental Hygiene Science has established that the accumulation of plaque containing bacteria in the sub gum “Gingival Sulcus” spaces of the mouth produces acids and enzymes that, if they accumulate, may lead to a hard mineral deposit called Calculus (Tartar) and may contribute to periodontal (gum) disease. It is established that if plaque is removed daily the teeth and gums remain healthy. Daily brushing of teeth is essential to controlling plaque. Daily that flossing between the teeth below the gum line within the gingival sulcus is an essential complement to daily tooth brushing above the gum line.
The common standard “Flossing by Hand” method (hereafter called the ‘by hand’ method) is, effectively, stated as follows:
A: Lightly wrap floss around the middle finger of both hands to secure the fixed ends of an approximately two inch span of floss.
B: Hold the floss with the thumb and index finger of each hand where it is wrapped around the corresponding middle fingers to be able to firmly hold the floss.
C: Place both hands into your mouth and draw the floss loosely over the tight space between the adjacent teeth to be flossed.
D: With your thumb and index fingers pressing the floss into the tight spot between adjacent teeth and gently draw the floss back and forth until the floss is straight through the tight spot between adjacent teeth, but still remaining above the gum line.
E: Relax the floss tension and draw the floss around the tooth by moving the fingers in along both sides of the line of teeth to create a wraparound “C” path of floss wrapping around the tooth.
F: Gently tension the floss and draw the floss back and forth, and up and down, around the surface of the tooth above and below the gum line simultaneously dislodging plaque and drawing the plaque out from the bottom of the gingival sulcus.
G: When finished with one tooth lift the floss loosely out of the gingival sulcus but staying below the tight spot between the adjacent teeth.
H: Draw the floss away in the opposite direction onto the adjacent tooth reversing the “C” shape of the floss along the tooth line and again wrapping the floss around the adjacent tooth and repeat step from step E:.
I: When finished flossing two adjacent teeth loosely lift the floss out of the gingival sulcus to below the tight spot between the adjacent teeth and preferably roll both hand's fingers over onto the same side (commonly the internal side) of the line of teeth and pull the floss out sideways employing the same processes as used in inserting floss in through a tight space between adjacent teeth. The sideways withdrawal forestalls damaging or lifting off dental caps or posts.
J: Advance fresh floss by unwinding and rewinding the floss around the middle fingers, and repeat throughout the mouth.
Many manual devices have been designed, with either brushes or floss, to deliver in-mouth inter-dental cleansing with devices that are held outside the mouth. These devices can be categorized as either “disposable” or “refillable”.
Brushes are usually either disposable or have disposable bristles attached to a reusable handle; e.g. U.S. Pat. No. 4,828,420
Most disposable hand flossing devices are plastic yolks that have a fixed length of stretched floss across at the distal ends of a yolk at the; e.g. U.S. Pat. No. D577462 S.
Most refillable hand flossing devices also have a fixed length of floss stretched straight across a wide yolk at the distal ends, and employ a variety of ways to re-stretch a new fixed length of floss advanced from a floss source compartment in the handle; e.g. U.S. Pat. Nos. 3,759,272, 4,022,229, 5,287,865,5269331. The default method for using fixed stretched flossing yolk devices is distinct from the common ‘by hand’ method (described above). The default fixed stretched floss yolk method of flossing is effectively as follows:
A: If the device is refillable you must insure that the floss is drawn across the yolk by two fixed, secured ends, otherwise a disposable device already has fixed tension span of floss. Then place the device in the mouth and place the floss onto the space between adjacent teeth
B: Pull the floss tight back and forth across the tight spot by moving the yolk back and forth while lightly pressing the yolk in beyond the tight spot between the adjacent teeth.
C: Under the tight spot pull the stretched straight floss around the tooth as much as possible and draw the floss across the tooth by moving the yolk back and forth laterally.
D: When finished with one tooth lift the floss out of the gingival sulcus but remain below the tight spot between the adjacent teeth and draw the floss over toward the adjacent tooth and repeat (C:)
E: When finished with both adjacent teeth pull the floss across the tight spot by moving the floss back and forth by pulling the yolk back and forth while lightly pulling the yolk out above the tight spot between the adjacent teeth.
F: If the device is refillable, release the fixed ends, advance fresh floss, and re-secure the fixed ends. If the device is disposable, replace the device as needed. Repeat from A:.
Inter-dental brushes often have disposable conic shaped bristles radiating orthogonally from a central spine mounted on a handle. The method to use these brushes is simply press them in and out sideways through the space below the tight spot and above the gum line between adjacent teeth.